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Cardiovascular and Metabolic Risk
Prevalence and major risk factors of type 2 diabetes mellitus among adult psychiatric inpatients from 2005 to 2018 in Beijing, China: a longitudinal observational study
  1. Fude Yang1,
  2. Qiuyue Ma2,
  3. Jue Liu2,
  4. Botao Ma1,
  5. Moning Guo3,
  6. Fangchao Liu2,
  7. Juan Li4,
  8. Zhiren Wang1,
  9. Min Liu2
  1. 1Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
  2. 2Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
  3. 3Beijing Municipal Commission of Health and Family Planning Information Center, Beijing Municipal Commission of Health and Family Planning Policy Research Center, Beijing, China
  4. 4Beijing Geriatric Hospital, Beijing, China
  1. Correspondence to Dr Min Liu; liumin{at}bjmu.edu.cn; Dr Fude Yang; yangfd200{at}126.com

Abstract

Objective We aim to investigate the prevalence, trends, and major risk factors of type 2 diabetes mellitus (T2DM) among adult psychiatric inpatients in Beijing, China.

Research design and methods We did a longitudinal observational study using data from the Beijing Municipal Commission of Health and Family Planning Information Center, including 157 570 adult psychiatric inpatients in 19 specialized psychiatric hospitals from 2005 to 2018 in Beijing. Data on demographic characteristics and antipsychotic medication use were obtained from electronic health records. Schizophrenia, T2DM, and comorbidities were defined according to the International Classification of Diseases, 10th revision codes of discharge diagnosis. The overall prevalence of T2DM in adult psychiatric inpatients was calculated, and the annual prevalence of T2DM was calculated and adjusted to the overall participant population. Univariate and multivariate logistic regression analyses were performed to obtain crude ORs and adjusted ORs (aORs) on the risk of T2DM in patients with different demographic characteristics, schizophrenia, antipsychotic medication use, and different comorbidities. Age-specific prevalence of T2DM under a stratification of schizophrenia or other psychiatric disorders was calculated in the subgroup analysis.

Results Out of 157 570 adult inpatients, 16 939 had T2DM, with a prevalence of 10.75% (95% CI 10.60% to 10.90%). The prevalence was 11.63% (95% CI 11.37% to 11.88%) among patients with schizophrenia and 10.17% (95% CI 9.98% to 10.37%) among patients with other psychiatric disorders. During 2005–2018, the prevalence of T2DM in adult patients increased over the years, from an adjusted prevalence of 5.20% in 2005, to 10.98% in 2010, 12.50% in 2015, and 12.71% in 2018. Results from the multivariate analysis showed that increasing age, diagnosis of schizophrenia (aOR=1.23, 95% CI 1.18 to 1.29), and comorbidities of hypertension (aOR=3.09, 95% CI 2.97 to 3.22), lipid disorders (aOR=1.95, 95% CI 1.88 to 2.04), and fatty liver (aOR=1.93, 95% CI 1.84 to 2.03) were major risk factors of T2DM in adult psychiatric inpatients.

Conclusions The prevalence of T2DM was high among adult psychiatric inpatients in Beijing, China. Elderly patients, those with schizophrenia, and those with hypertension, lipid disorders, and fatty liver had higher prevalence of T2DM. Prevention and treatment of T2DM are of utmost relevance in hospitalized psychiatric patients.

  • type 2 diabetes
  • mental disorders
  • schizophrenia
  • China
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2019-000996

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    Footnotes

    • FY and QM contributed equally.

    • Contributors QM and FY searched the literature, designed the study, analyzed the data, interpreted the results, and drafted the manuscript. JLiu, BM, MG, FL, JLi and ZW collected the data and revised the manuscript. ML conceived, designed and supervised the study, interpreted the results, and revised the manuscript. All authors have approved the final version of the manuscript. ML is the guarantor.

    • Funding This work was supported by the National Natural Science Foundation of China (grant numbers 71874003 and 81703240). The funder had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had access to all data in the study and had final responsibility for the decision to submit for publication.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study used information that is available in the database of the Beijing Municipal Commission of Health and Family Planning Information Center, and all identifiable information was removed.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data may be obtained from a third party and are not publicly available.